﻿<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
    <head>
        <meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
        <title>Курьер</title>
        <style type="text/css">
        	<!--

        	.css1 {
        		color: #FFF;
        		font-size: 14px;
        		font-family: Tahoma, Geneva, sans-serif;
        	}

        	.css2 {
        		color: #F00;
        	}

        	textarea#form_3 {
        		width: 250px;
        		height: 100px;
        	}

        	textarea#form_11 {
        		width: 250px;
        		height: 100px;
        	}

        	textarea#form_10 {
        		width: 600px;
        		height: 100px;
        	}

        	textarea#form_7 {
        		width: 250px;
        		height: 100px;
        	}

        	textarea#form_4 {
        		width: 250px;
        		height: 100px;
        	}
-->
        </style>
        <script type='text/JavaScript' src='scw.js'> </script>
    </head>

    <body>
        <table width="899" border="1" cellpadding="1" cellspacing="1" bgcolor="#D6D6D6">
            <col width="282" />
            <col width="216" />
            <col width="193" />
            <col width="227" />
            <tr>
                <td width="196" align="right">Планируемая    дата</td>
                <td colspan="5"><input name="form_65" type="text" id="form_65" value="" size="8" onclick=" scwShow(this, event); "/>
                    &nbsp;</td>
            </tr>
            <tr>
                <td align="right">Отдать/получить/купить</td>
                <td colspan="5">
                    <select name="form_required_12"><option selected="selected"></option>
                        <option>Отдать</option>
                        <option>Получить</option>
                        <option>Купить</option>
                    </select>
                </td>&nbsp;  </tr>
            <tr>
                <td align="right">Наименование груза    </td>
                <td colspan="5"><input name="form_1" type="text" id="form_1" value="" size="100" />&nbsp;</td>
            </tr>
            <tr>
                <td align="right">Доверенность    </td>
                <td colspan="5">
                    <select name="form_required_14"><option selected="selected"></option>
                        <option>да</option>
                        <option>нет</option>
      
                    </select></td>
            </tr>
            <tr>
                <td align="right">№ счета</td>
                <td colspan="5"><input name="form_2" type="text" id="form_2" value="" />&nbsp;</td>
            </tr>
            <tr>
                <td colspan="6">&nbsp;</td>
            </tr>
            <tr>
                <td colspan="6" align="center" bgcolor="#000000" class="css1">Загрузка</td>
            </tr>
            <tr>
                <td colspan="2" valign="top" bgcolor="#D6D6D6">Адрес места    загрузки      
                    <textarea id="form_3" name="form_3"></textarea></td>
                <td colspan="2" valign="top" bgcolor="#D6D6D6">Название фирмы
                    <textarea id="form_4" name="form_4"></textarea>&nbsp;</td>
                <td width="243" align="left" valign="top" bgcolor="#D6D6D6">Контактное лицо
                    <input name="form_5" type="text" id="form_5" value="" size="40" />      &nbsp;</td>
                <td width="240" align="left" valign="top" bgcolor="#D6D6D6">Телефон
                    <input name="form_6" type="text" id="form_6" value="" size="40" />&nbsp;</td>
            </tr>
            <tr>
                <td colspan="6" align="center" bgcolor="#000000" class="css1">Разгрузка</td>
            </tr>
            <tr>
                <td colspan="2" valign="top" bgcolor="#D6D6D6">Адрес места    разгрузки      
                    <textarea id="form_11" name="form_11"></textarea></td>
                <td colspan="2" valign="top" bgcolor="#D6D6D6">Название фирмы
                    <textarea id="form_7" name="form_7"></textarea>&nbsp;</td>
                <td align="left" valign="top" bgcolor="#D6D6D6">Контактное лицо
                    <input name="form_8" type="text" id="form_8" value="" size="40" />      &nbsp;</td>
                <td align="left" valign="top" bgcolor="#D6D6D6">Телефон
                    <input name="form_9" type="text" id="form_9" value="" size="40" />      &nbsp;</td>
            </tr>
            <tr>
                <td colspan="6" bgcolor="#000000">&nbsp;</td>
            </tr>
            <tr>
                <td colspan="6" align="center"><p>Примечание</p>
                    <p>
                        <textarea id="form_10" name="form_10"></textarea>
                        &nbsp;</p></td>
            </tr>
            <tr>
                <td height="19" colspan="6" align="left" class="css2">&nbsp;</td>
            </tr>
        </table>
    </body>
</html>